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Care Coordinator UM/CM (RN)

HCSC - Downers Grove, IL

***Due to needs of the business, this role will be required to work every third weekend of the month with a comp day during the week. This will also be a work from home role*** BASIC FUNCTION: This position is responsible for performing concurrent review in accordance with approved departmental guidelines; performing discharge planning and identifying...

Senior Paralegal

HCSC - Chicago, IL

BASIC FUNCTION: This position is for a paralegal as a member of the Corporate Legal Services Team. This paralegal provides strategic oversight and coordination of multi-state licensing and regulatory requirements and filings, supports corporate governance function (e.g minute maintenance, meeting records, resolutions) and provides legal advice and support of other comp...

Medical Reviewer LPN

HCSC - Albuquerque, NM

BASIC FUNCTION: This position is responsible for pre-authorization reviews in accordance with the medical contract and regulations, medical criteria, utilization review, and quality of care. JOB REQUIREMENTS: * LPN with valid, current, unrestricted clinical license in the state of New Mexico. * 3 years of clinical experience in...

Assoc Infra Svc Del Analyst

HCSC - Richardson, TX

Job Purpose: This position is responsible for handling 24x7 operations infrastructure support services of all non-production and production environments in the area of responsibility; handling the use of analytics to improve service, availability, and customer interactions; handling incident resolution and issues escalated by vendors; transitioning knowledg...

Policy Administration Assoc- Lombard, IL

HCSC - Lombard, IL

** THIS POSITION WILL BE REMOTE UNTIL A RETURN TO OFFICE DATE IS ESTABLISHED. APPLICANTS NEED TO LIVE A COMMUTABLE DISTANCE TO LOMBARD, IL** BASIC FUNCTION: Under supervision, this position is responsible for processing benefit changes, reworking, rewriting, terminations, adding new product lines and providing basic overall group pol...

Sr Client Consultant

HCSC - Richardson, TX

BASIC FUNCTION: In this role, you will be responsible for creating medical plan review presentations for BCBSTX employer group clients and for presenting those reviews to the client. Creating the medical plan reviews and providing additional ad hoc analytics in support to your book of key accounts will require you to analyze health claims utilization and cos...

Sr Business Consultant

HCSC - Chicago, IL

Job Purpose: This position is responsible for providing business analysis and leadership to ensure alignment and integration across functional areas in support of divisional strategies and to ensure consistency and efficiency requiring leadership of major, complex, and strategic cross-divisional and enterprise-wide projects from inception to completion; oversight coordinati...

IT Delivery Consultant

HCSC - Chicago, IL

As the health care industry continues to rapidly transform, our IT team conceives, develops and delivers impactful technology solutions to support access to quality, affordable health care for our members. We are driven by our collective company purpose: To do everything in our power to stand with our members in sickness and in health®. Our IT team unleashes the pow...

Assistant IT Product Manager

HCSC - Chicago, IL

As the health care industry continues to rapidly transform, our IT team conceives, develops and delivers impactful technology solutions to support access to quality, affordable health care for our members. We are driven by our collective company purpose: To do everything in our power to stand with our members in sickness and in health®. Our IT team unleashes the pow...

User Acceptance Tester

HCSC - Richardson, TX

Job Purpose: This position is responsible for evaluating requirements for testing new or modified products and documentation prior to production release. Designing, developing, creating, and executing test plans and cases based on software requirements and technical understanding of product architecture, as well as business processes and procedures. Executing various sys...

Sr Systems Analyst

HCSC - Richardson, TX

Job Purpose: This position is responsible for designing enhancements and new business applications and/or information systems solutions through integration of technical and business requirements; serving as technical designer to identify best solution and resulting technical specifications within limits of code environment; linking Business Analyst needs and Architect defin...

Sr Clerical Support

HCSC - Abilene, TX

* Please note – candidates moving forward to next steps will be required to complete a video interview via HireVue. * BASIC FUNCTION: Under supervision, this position is responsible for performing complex clerical duties of a varied nature requiring exercising judgment. JOB REQUIREMENTS: *High School Diplo...

Health Advocate Concierge

HCSC - United States of America

**If hired in Chicago or Naperville, this will be a union role** **If chosen to proceed, each candidate will be required to complete a video interview via HireVue** Job Purpose: This position is responsible for an integrated member experience. Responsible for providing concierge guidance and ...

Government Programs Compliance Consultant

HCSC - Albuquerque, NM

Job Purpose: This position is responsible for supporting evaluation of Government Programs (Medicare and Medicaid) regulations, guidance and contracts, assessing the risk that those items present with respect to HCSC government contracts; supporting the Compliance Department oversight of the business operational compliance with the requirements through multiple mechanisms such ...

Accreditation Program Coordinator

HCSC - Tulsa, OK

BASIC FUNCTION: This position is responsible for the successful completion of projects and written documentation of standards to meet external accreditation requirements (NCQA, URAC, etc.), coordinating the activities with internal areas at the Enterprise and plan levels of the company and with external accreditation agencies, monitoring department activ...